Athlete’s Foot (Foot and Toe Ringworm)
Athlete’s foot is a common fungal infection of the skin, affecting the feet and toes. The medical term for athlete’s foot is tinea pedis. As with most fungal infections of the skin, it is also known as a ringworm infection. However, athlete’s foot is not due to a worm. The fungus that infects the skin is known as a dermatophyte which specifically targets human skin. Athlete’s foot can be persistent and may take weeks or months of treatment to resolve. It often recurs largely due to repeating the lifestyle habits that contributes to its development. Athlete’s foots is a common occurrence in South Africa often associated with the hot climate.
The outermost layers of the skin are made up of dead, protein-laden cells. This protein known as keratin forms a physical barrier that protects the internal environment of the body from the exterior. However, certain species of fungi known as dermatophytes have the ability to digest this keratin and infect the skin. Dermatophytes cause a superficial skin infection, meaning that while it can spread on the surface of the skin it cannot penetrate into the deeper layers or living tissue underneath it.
There are several types of dermatophytes that can infect the skin. It is important to understand that dermatophytes are not the same as yeasts, although both microorganisms fall under the category of fungi. Yeasts may infect the skin when there is a break in it particularly at the fold. However, yeasts tend to thrive within body cavities, like the mouth and vagina, while dermatophytes survive on the surface of the skin. It is impossible not to be exposed to dermatophytes as it is prevalent in the environment but an infection may not occur in every person.
Many dermatophytes are common found throughout the world, although regional differences may make some dermatophytes more prevalent in infections such as athlete’s foot. Some may be found in the soil, others on animals but many are spread directly from one person to another. Athlete’s foots is not a condition associated with hygiene. The foot is the ideal environment for fungi to thrive, as it is often closed off from light and air and is warm. Coupled with the sweat from the skin, the fungi have all the factors that it needs to survive and thrive.
The risk of contracting athlete’s foots is greater when using public facilities where water may make contact with the bare foot. Gym and communal pool showers are among the hot spots. Living with a person who has athlete’s foot can increase the chance of others in the house contracting the infection. Personal items like socks and shoes should never be shared. The feet should be left bare and allowed to air as often as possible. However, walking barefoot outdoors can increase the risk of athlete’s foot as tiny cuts may develop and soil fungi may infect the skin. There is some evidence to suggest that some people may be genetically predisposed to contracting fungal skin infections.
The webs between the toes and sides of the feet are the most commonly affected areas in tinea pedis. The rash may not have the typical round ring-like appearance that is seen in other types of dermatophytosis.
- Craking or peeling skin
- Itchy skin rash on the feet.
- Tiny fluid-filled vesicles.
- Shedding skin particularly when scratching (like dandruff on the feet).
- Redness of the skin with slightly raised borders.
- White peeling rash between the toes.
Many people who have athlete’s foot may not know that they have it at the outset. Itching of the feet, particularly when it is constant despite being dry and well ventilated, may be one of the first symptoms of athlete’s foot.
The medical treatment for athlete’s foot involves the use of oral and topical antifungal agents. It has to be used for 4 to 6 weeks and sometimes longer. Various lifestyle measures need to be implemented, like avoiding showering in a public facility, using sandals or flip-flops when walking in public areas with stagnant water, not sharing person items like socks and shoes as well as avoiding closed shoes as far as possible. Fungal spores can survive in socks and shoes for long periods of time even without human skin to feed on. Therefore these items may have to be discarded after treatment is commenced.
There is no significant dietary modification that can be helpful in athlete’s foot. One of the main herbal medicines used is tea tree oil (Melaleuca officinalis). It can be used in a 5% or 10% concentration within carriers like aqueous cream. While 100% tea tree oil is very effective in destroying the fungus, it can also irritate the skin and cause drying and cracking. This may increase the risk of being re-infected. Oils containing diluted tea tree may be a better option.
Homeopathic remedies that can treat athlete’s foot can vary. Some of these remedies are specific to one person with athlete’s foot but may not be as effective in others with the same condition. It is therefore important to consult with a homeopath for a specific prescription that can be used to eradicate athlete’s foot and ease the symptoms.